1699799387 NPI number — JOHN W FUCHS DO

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699799387 NPI number — JOHN W FUCHS DO

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

FUCHS

Provider First Name:

JOHN

Provider Middle Name:

W

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

DO

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1699799387

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/27/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

623 122ND STREET CT NW

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GIG HARBOR

Provider Business Mailing Address State Name:

WA

Provider Business Mailing Address Postal Code:

98332-9611

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

253-851-5431

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

623 122ND STREET CT NW

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

GIG HARBOR

Provider Business Practice Location Address State Name:

WA

Provider Business Practice Location Address Postal Code:

98332-9611

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

253-851-5431

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/26/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Q00000X , with the licence number:  OP00000661 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0204575 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0204582 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8940605 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0202832 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0214109 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8940603 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0223271 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8945092 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8940604 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 0204580 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
• Identifier: 8412447 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: 8940318 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".